Considerations for Successful Treatment-Free Remission in Chronic Myeloid Leukemia

BCR-ABL1 tyrosine kinase inhibitors have dramatically improved outcomes for patients with chronic myeloid leukemia, and current studies are investigating whether some patients may be able to suspend therapy yet maintain response in a state known as “treatment-free remission” (TFR). Results from ongoing studies suggest that ≈ 40% to 60% of patients in sustained (generally ≥ 2 years) deep molecular response (defined as a 4-log or deeper reduction in BCR-ABL1 transcripts, depending on the study) who attempt TFR may successfully remain off treatment.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Article Source Type: research

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Publication date: Available online 25 June 2018Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Avi Leader, Noam Benyamini, Anat Gafter-Gvili, Juliet Dreyer, Bronya Calvarysky, Alina Amitai, Osnat Yarchovsky-Dolberg, Giora Sharf, Eric Tousset, Opher Caspi, Martin Ellis, Itai Levi, Sabina De Geest, Pia RaananiAbstractBackgroundNonadherence to tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML) has been associated with inferior outcomes. Scarce evidence exists on the effectiveness of adherence-enhancing interventions. The present pilot study evaluated the feasibility and effectiveness of an interventi...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 18 June 2018Source: The Lancet HaematologyAuthor(s): Gita Thanarajasingam, Lori M Minasian, Frederic Baron, Franco Cavalli, R Angelo De Claro, Amylou C Dueck, Tarec C El-Galaly, Neil Everest, Jan Geissler, Christian Gisselbrecht, John Gribben, Mary Horowitz, S Percy Ivy, Caron A Jacobson, Armand Keating, Paul G Kluetz, Aviva Krauss, Yok Lam Kwong, Richard F Little, Francois-Xavier MahonSummaryTremendous progress in treatment and outcomes has been achieved across the whole range of haematological malignancies in the past two decades. Although cure rates for aggressive malignancies have inc...
Source: The Lancet Haematology - Category: Hematology Source Type: research
ConclusionThese results suggest that mutational analysis is invaluable for choosing an appropriate second-line TKI in Asia.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 4 July 2018Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Pradnya Chopade, Luke P. AkardAbstractMost patients with chronic myeloid leukemia (CML) receiving treatment with BCR-ABL1 tyrosine kinase inhibitors (TKIs) achieve favorable responses; moreover, TKI therapy enables patients to achieve long-term survival, with survival rates similar to those of individuals without CML. This enhanced survival has resulted from the availability of multiple BCR-ABL1 TKIs with efficacy not only in frontline treatment, but importantly, also in second- and third-line treatment. Here, we review t...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionIn real life, ponatinib is a “niche-drug” reserved for a unique population of exceptionally young patients with CML with or without the T315I mutation. In this highly selected group, very different from the PACE cohort, ponatinib achieved high overall response rates.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 25 June 2018Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Avi Leader, Noam Benyamini, Anat Gafter – Gvili, Juliet Dreyer, Bronya Calvarysky, Alina Amitai, Osnat Yarchovsky-Dolberg, Giora Sharf, Eric Tousset, Opher Caspi, Martin Ellis, Itai Levi, Sabina De Geest, Pia RaananiAbstractBackgroundNon-adherence to tyrosine kinase inhibitors in chronic myeloid leukemia is associated with inferior outcomes. Scarce evidence exists on effectiveness of adherence enhancing interventions. This pilot study aimed to evaluate the feasibility and effectiveness of an intervention to improve...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
This study aimed to evaluate correlates of TKI NA using EM and test the diagnostic accuracy of subjective adherence measures.Patients and MethodsCML patients receiving a TKI for any duration were enrolled at 4 hematology institutes, and adherence was measured for 4 months. EM adherence was the reference adherence measure, expressed as the percentage of days with the drug taken as prescribed. Subjective adherence was measured using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) self-report and clinician-reported visual analog scale (VAS) at 2 time points. Baseline theory–derived corr...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: June 2018Source: Clinical Lymphoma Myeloma and Leukemia, Volume 18, Issue 6Author(s): Giuseppe Saglio, Giora Sharf, Antonio Almeida, Andrija Bogdanovic, Felice Bombaci, Jelena Čugurović, Nigel Deekes, Valentín Garcia-Gutiérrez, Jan de Jong, Šarūnas Narbutas, Peter Westerweel, Daniela ZackovaAbstractTreatment-free remission (TFR) after discontinuation of tyrosine kinase inhibitor therapy is now an emerging treatment goal for patients with chronic myeloid leukemia, who have achieved a deep and stable response to treatment. Although guidance is now available, patients’ questions...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 18 June 2018Source: The Lancet HaematologyAuthor(s): Gita Thanarajasingam, Lori M Minasian, Frederic Baron, Franco Cavalli, R Angelo De Claro, Amylou C Dueck, Tarec C El-Galaly, Neil Everest, Jan Geissler, Christian Gisselbrecht, John Gribben, Mary Horowitz, S Percy Ivy, Caron A Jacobson, Armand Keating, Paul G Kluetz, Aviva Krauss, Yok Lam Kwong, Richard F Little, Francois-Xavier MahonSummaryTremendous progress in treatment and outcomes has been achieved across the whole range of haematological malignancies in the past two decades. Although cure rates for aggressive malignancies have inc...
Source: The Lancet Haematology - Category: Hematology Source Type: research
ConclusionThese results suggest that mutational analysis is invaluable for choosing an appropriate second-line TKI in Asia.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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